Transcript bend and lift screen

ACE Personal Trainer Manual
5th Edition
Chapter 7: Functional Assessments: Posture, Movement, Core,
Balance, and Flexibility
Lesson 7.2
LEARNING OBJECTIVES
• After completing this session, you will be able to:
 Demonstrate and explain five primary movements
performed in activities of daily living (ADL)
 Demonstrate proper protocol for four movement
screens
 Evaluate and interpret movement compensations
using four movement screens
 Demonstrate proper protocol for four flexibility
assessments
 Evaluate and interpret four flexibility assessments
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FIVE BASIC MOVEMENTS
• Movement can be described by
five basic movements performed
during many daily activities:
 Bending and lifting movements
(e.g., squatting)
 Single-leg movements
 Pushing movements
 Pulling movements
 Rotational movements
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MOVEMENT SCREENS
• Generally challenge clients
with no recognized
pathologies to perform basic
movements
• Help evaluate a client’s
stability and mobility
throughout the entire kinetic
chain
• If pain arises during a screen,
stop and refer the client to a
healthcare provider.
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BEND AND LIFT SCREEN
• Objective: To examine symmetrical lower-extremity mobility
and stability, and upper-extremity stability during a bendand-lift movement
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BEND AND LIFT SCREEN
•
Observations–frontal view
 First repetition
o
Observe the stability of the
foot.
 Second repetition
o
Observe the alignment of
the knees over the second
toe.
 Third repetition
o
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Observe the overall
symmetry of the entire body
over the base of support.
BEND AND LIFT SCREEN
• Observations–sagittal view
 First repetition
o Observe whether the heel remains in
contact with the floor.
 Second repetition
o Determine whether the client exhibits
“glute” or “quadriceps” dominance.
 Third repetition
o Observe whether the client achieves a
parallel position between tibia and
torso in the lowered position while
controlling the descent phase.
 Fourth repetition
o Observe the degree of lordosis in the
lumbar/thoracic spine during lowering
and in the lowered position.
 Fifth repetition
o Observe any changes in head position
during the lowering phase.
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HURDLE STEP SCREEN
• Objective: To examine simultaneous mobility of one limb and
stability of the contralateral limb while maintaining both hip and
torso stabilization during a balance challenge of standing on one leg
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HURDLE STEP SCREEN
• Observations–frontal view
 First repetition
o Observe the stability of the foot.
 Second repetition
o Observe the alignment of the stance-leg knee
over the foot.
 Third repetition
o Watch for excessive hip adduction >2 inches (5.1
cm) as measured by excessive stance-leg
adduction or downward hip-tilting toward the
opposite side.
 Fourth repetition
o Observe stability of the torso.
 Fifth repetition
o Observe alignment of the moving leg.
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HURDLE STEP SCREEN
• Observations–sagittal view
 First repetition
o Observe the stability of the torso
and stance leg.
 Second repetition
o Observe the mobility of the hip.
 General interpretations
o Identify origin(s) of movement
limitation or compensation.
o Evaluate impact on the entire
kinetic chain.
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SHOULDER PUSH STABILIZATION SCREEN
•
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Objective: To examine
stabilization of the
scapulothoracic joint and
core control during closedkinetic-chain pushing
movements
SHOULDER PUSH STABILIZATION SCREEN
• Observations:
 Observe any notable changes in the position of the
scapulae relative to the rib cage at both end-ranges of
motion.
 Observe for lumbar hyperextension in the press position.
• General interpretations:
 Identify origin(s) of movement limitation or compensation.
 Evaluate impact on the entire kinetic chain
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THORACIC SPINE MOBILITY SCREEN
• Objective: To examine bilateral mobility of the thoracic
spine.
 Lumbar spine rotation is considered insignificant, as it only
offers approximately 15 degrees of rotation.
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THORACIC SPINE MOBILITY SCREEN
• Observations:
 Observe any bilateral discrepancies between the
rotations in each direction.
• General interpretations:
 Identify origin(s) of movement limitation or
compensation.
 This screen evaluates trunk rotation in the
transverse plane. Therefore, any lateral flexion of
the trunk (dowel tilting up or down) must be
avoided.
 Evaluate impact on entire kinetic chain.
 The lumbar spine generally exhibits limited
rotation of approximately 15 degrees, with
balance of trunk rotation occurring through the
thoracic spine.
 If thoracic spine mobility is limited, the body
strives to gain movement in alternative planes
within the lumbar spine.
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THORACIC SPINE MOBILITY SCREEN
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FLEXIBILITY AND MUSCLE-LENGTH TESTING
• Assess the flexibility of specific muscle groups where
tightness or limitations to movement is suspected.
• Become familiar with normal ranges of motion for
healthy adults (refer to Figures 7-33 and 7-34).
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FLEXIBILITY ASSESSMENT WORKSHEET
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THOMAS TEST - HIP FLEXION/QUADRICEPS LENGTH
• Objective: To assess the length of the muscles involved in hip flexion
 Hip flexors or iliopsoas and rectus femoris
 This test should not be conducted on clients suffering from low-back
pain, without medical clearance.
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THOMAS TEST - HIP FLEXION/QUADRICEPS LENGTH
• Observe whether:
 The back of the lowered thigh touches the table (hips positioned in 10
degrees of extension)
 The knee of the lowered leg achieves 80 degrees of flexion
 The knee remains aligned straight or falls into internal or external rotation
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PASSIVE STRAIGHT-LEG RAISE
• Objective: To assess the length of the hamstrings
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PASSIVE STRAIGHT-LEG RAISE
• Observation: Note the degree of movement attained
from the table or mat before the spine compresses the
hand under the low back or the opposite leg begins to
show visible signs of lifting off the table or mat.
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SHOULDER MOBILITY TESTS
• Shoulder
flexionextension test
• Internalexternal
rotation test of
the humerus
• Apley’s scratch
test
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SHOULDER MOBILITY TEST - FLEXION
• Objective: To assess the degree of shoulder flexion
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SHOULDER MOBILITY TEST - EXTENSION
• Objective: To assess the degree of shoulder extension
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SHOULDER ROTATION - EXTERNAL
•
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Objective: To assess external rotation of the humerus at
the shoulder joint to evaluate medial rotators
SHOULDER ROTATION - INTERNAL
• Objective: To assess external rotation of the humerus at
the shoulder joint to evaluate lateral rotators
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SHOULDER ROTATION - EXTERNAL/INTERNAL
• Observations:
 Measure the degree of movement in each
direction.
 Note any bilateral differences between the
left and right arms in performing both
movements.
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SHOULDER MOBILITY - APLEY’S SCRATCH TEST
• Objective: To assess simultaneous movements of the
shoulder girdle (primarily the scapulothoracic and
glenohumeral joints)
 Shoulder extension and flexion
 Internal and external rotation of the humerus at the
shoulder
 Scapular abduction and adduction
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SHOULDER MOBILITY - APLEY’S SCRATCH TEST
• Ability to touch the medial border of the contralateral scapula
or how far down the spine the client can reach with shoulder
flexion and external rotation.
• Ability to touch the opposite inferior angle of the scapula or
how far up the spine the client can reach with shoulder
extension and internal rotation.
• Observe any bilateral differences between the left and right
arms in performing both movements.
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SUMMARY
• Movement can be described by five basic movements
performed during many daily activities.
• Movement screens help evaluate a client’s stability and
mobility throughout the entire kinetic chain.
• Flexibility tests assess the flexibility of specific muscle
groups where tightness or limitations to movement is
suspected.
© 2014 ACE